Provider Demographics
NPI:1780641811
Name:BRUMLEY, LYNDA W (MD)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:W
Last Name:BRUMLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 KESSLER ST
Mailing Address - Street 2:STE 300
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204
Mailing Address - Country:US
Mailing Address - Phone:913-632-2900
Mailing Address - Fax:913-632-2999
Practice Address - Street 1:7450 KESSLER ST
Practice Address - Street 2:STE 300
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-632-2900
Practice Address - Fax:913-632-2999
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7P46207RG0300X
KS04-24629207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO20189777OtherHUMANA
MO24321033OtherBLUE CROSS BLUE SHIELD
MOP878862Medicare ID - Type Unspecified
G 07013Medicare UPIN
MO20189777OtherHUMANA
MO24321033OtherBLUE CROSS BLUE SHIELD